TCR-Nurse Flashcards

A patient arrives after a high-speed MVC with a seat-belt sign across the abdomen. Which injury pattern should the trauma nurse suspect?

Answer: Chance fracture with hollow viscus injury

A seat-belt sign across the abdomen is classically associated with Chance fractures (lumbar flexion-distraction) and hollow viscus (bowel) injuries from the lap belt.

Which crystalloid solution is preferred in damage control resuscitation for hemorrhagic shock?

Answer: Balanced resuscitation with PRBCs, FFP, and platelets in 1:1:1 ratio

Damage control resuscitation uses PRBCs, FFP, and platelets in a 1:1:1 ratio to replicate whole blood and correct trauma-induced coagulopathy.

A geriatric trauma patient takes beta-blockers daily. Which assessment finding may be masked by this medication?

Answer: Tachycardia

Beta-blockers blunt the compensatory tachycardia response to hemorrhage, making heart rate an unreliable indicator of shock in these patients.

A patient with a pelvic fracture from a crush injury has ongoing hemodynamic instability despite resuscitation. Which intervention should the trauma nurse anticipate FIRST?

Answer: Application of a pelvic binder

A pelvic binder is the immediate intervention to reduce pelvic volume and tamponade venous bleeding before more definitive treatment.

Tranexamic acid (TXA) is MOST effective when given within what time frame after injury?

Answer: Within 3 hours

TXA reduces mortality when given within 3 hours of injury; evidence from the CRASH-2 trial shows no benefit and possible harm when given after 3 hours.

An unconscious trauma patient has a suspected cervical spine injury. Which airway method is PREFERRED?

Answer: Rapid sequence intubation (RSI) with in-line stabilization

RSI with manual in-line cervical stabilization is the preferred method as it protects the airway while minimizing cervical movement.

A trauma patient is found to have a base deficit of -8 mEq/L. This finding indicates:

Answer: Significant tissue hypoperfusion and acidosis

A base deficit more negative than -6 mEq/L indicates significant metabolic acidosis from tissue hypoperfusion and is associated with increased mortality.